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AU2017 Gen Path Exam 3 > Lecture 1- Gastrointestinal Pathology 1 > Flashcards

Lecture 1- Gastrointestinal Pathology 1 Flashcards

1
Q

…. …. can precede onset of lower GI disease, be present during GI disease, can persist after or reflect systemic alterations secondary to GI disease such as those seen with malabsorption

A

oral manifestations

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2
Q

the parotid gland is mainly ….

A

serous acni

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3
Q

sublingual glands are mainly …

A

mucous acini

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4
Q

submandibular and minor glands are mainly…

A

neither, they are mixed

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5
Q

What is the autoimmune disease that usually occurs in females 30s-50s that present with dry mouth and eyes (keratoconjunctivitis sicca) and intense lymphocytic infiltrate that replaces glandular tissue

A

Sjogren syndrome

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6
Q

Sjogren syndrome has an …. increased risk for lymphoma

A

40x

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7
Q

you can see a uni or bilateral enlargement in the parotid gland in … syndrome

A

sjogren

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8
Q

how often is sjogren syndrome secondary as opposed to primary?

A

60% of the time and occurs in setting of other autoimmune diseases

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9
Q

…% of salivary gland tumors are of the … gland and … of those are benign

A

75%

parotid

75%

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10
Q

2 types of benign salivary gland tumors

A

pleomorphic adenoma

warthrin tumor

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11
Q

most common malignant salivary gland tumor?

A

mucoepidermoid carcinoma

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12
Q

pleomorphic adenoma occurs …% of the time in the parotid

A

60%

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13
Q

T/F pleomorphic adenomas are lobulated and firm on palpitation

A

true

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14
Q

there is …% of recurrence with pleomorphic adenomas

A

10%

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15
Q

Can pleomorphic adenomas undergo malignant transformations?

A

yes

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16
Q

warthin tumor occurs only in the …. gland

A

parotid

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17
Q

T/F females are mostly affected my warthin tumors

A

false

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18
Q

…% of warthin tumors are bilateral

A

10%

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19
Q

warthin tumors are associated with…

A

smoking

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20
Q

where can mucoepidermoid carcinoma occur?

A

parotid and minor glands

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21
Q

what condition can there be a bluish color due to mucin and cystic growth pattern

A

mucoepidermoid carcinoma

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22
Q

… means the inability of the lower esophageal sphincter to relax

A

achalasia

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23
Q

esophageal obsrtuctions can be … or …

A

mechanical- post inflammatory fibrosis or stenosis

functional- discoordinated muscular contractions

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24
Q

… … can arise due to portal HTN and is seen in 90% of cirrhotic patients

A

esophageal varices

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25
Q

Are esophageal varices symptomatic or asymptomatic?

A

asymptomatic but can rupture and lead to a massive hemorrhage/death

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26
Q

extrinsic agents of esophagitis?

A 
chemicals
iatrogenic
infections
trauma
smoking
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27
Q

intrinsic agents of esophagitis

A

reflux (GERD)

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28
Q

acids, smoking and pill lodging are examples of … agents of esophagitis

A

extrinsic

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29
Q

chemo, radiation and graft vs. host diseases are examples of … agents of esophagitis

A

iatrogenic

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30
Q

fungal and viral causes of esophagitis are … agents and are more common in immuno-compromised patients

A

infectious

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31
Q

… esophagus is a complication of GERD with increased risk of adenocarcinoma

A

Barret

32
Q

T/F despite increased risk, most people with barrets do NOT develop tumors?

A

true

33
Q

… esophagus is intestinal metaplasia within the esophagus squamous mucosa

A

Barret

34
Q

2 diagnostic features for Barrett esophagus

A
  1. extension of abnormal mucosa above gastro-esophageal jxn

2. demonstration of squamous metaplasia

35
Q

… may be seen in patients with chronic gastric reflux (GERD, hiatal hernia, alcoholism and bulimia)

A

gastric acid enamel erosion

36
Q

enamel loss often affects which surfaces?

A

lingual/palatal

37
Q

extent of enamel loss in GI reflux may result … or …

A

duration

frequency

38
Q

2 benign esophageal neoplasms are?

A

leiomyoma

mucosal polyps

39
Q

esophageal malignancies account for …% of all GI cancer

A

8%

40
Q

2 types of malignant tumors in the esophagus

A

adenocarcinoma (barret)

squamous cell carcinoma

41
Q

squamous cell carcinoma is associated with … and … use

A

smoking

alcohol use

42
Q

SCC: tends to occur in males …:1 and especially african americans …:1 vs. white males

A

4: 1
6: 1

43
Q

what is the 5 year survival of Squamous Cell Carcinoma?

A

9%

44
Q

Adenocarcinoma is associated with … and tends to occur in males …:1 and is often detected late and has a …% 5 year survival rate

A

GERD

7:1

25%

45
Q

SCC occurs mostly in the … of the esophagus

A

middle third

46
Q

SCC has regional variation so it is most common where?

this may be due to geentics, environment or diet

A

china, brazil, south africa

47
Q

what can increase risk for SCC

A

dietary- vitamin def., fungal contam of food, nitrates and nitrosamines

SMOKING and alcohol

Plummer Vinson, achalasia, esophagitis

48
Q

which is more common worldwide? SCC or adenocarcinoma?

A

SCC

49
Q

adenocarcinoma usually affects the …. of the esophagus

A

distal third

50
Q

are caucasians or african americans more affected by adenocarcinoma?

A

caucasians

51
Q

autoimmune gastritis (which is chronic) is loss of the … cells which pump out acid. this leads to decreased … and decreased …. absorption which is … anemia

A

parietal

intrinsic factor

B12

pernicious

52
Q

what can cause acute gastritis

A

cigarettes, alcohol, stress, ischemia, NSAIDs, aspirin, infection

53
Q

symptoms of acute gastritis?

A

asymptomatic to epigastric pain to hemorrhage

54
Q

main cause of chronic gastritis?

A

infection, 90% of cases (helicobacter pylori)

55
Q

treatment of chornic gastritis caused by helicobacter pylori?

A

antibiotics and proton pump inhibitors

56
Q

what can cause peptic ulcer disease?

A

H.pylori, NSAID use

57
Q

peptic ulcer disease is …% duodenum or stomach

A

98%

58
Q

peptic ulcer disease: lifetime risk for males …% , lifetime risk for females …%

A

10%

4%

59
Q

peptic ulcer disease involves gastric … and recurrent … with intermittent …

A

hyperacidity

ulcers

healing

60
Q

peptic ulcer complications

A

intractable pain

hemorrhage
perforation (5%)

obstruction-edema, fibrosis (2%)

61
Q

4 causes of small intestine malabsorptive diarrhea

A

celiac disease: gluten allergen

tropical sprue

lactate deficiency

abetalipoproteinemia

62
Q

in caucasians, about 1 in…. have gluten sensitivity

A

100-200

63
Q

gluten sensitivity is actually a hypersensitivity to ….

A

gliadin

64
Q

morphology of gluten sensitivity

A

blunted villi

inflammatory infiltrate

65
Q

T/F symptoms of gluten sensitivity dramatically improve with withdrawal of wheat gliadin and related grain proteins from diet

A

true

66
Q

odynophagia is … and is a symptom of esophagitis along with dysphagia, heartburn and regurgitation of gastric contents

A

pain on swallowing

67
Q

…% of chronic gastritis cases are autoimmune (pernicious anemia)

A

10

68
Q

… is a curved gram-negative bacillus seen in most cases of chronic infectious gastritis

A

Helicobacter pylori

69
Q

… is a cause of small intestine malabsorptive diarrhea and it is a defect in transepithelial transport of mono and triglycerides

A

abetalipoproteinemia

70
Q

clinical aspects of malabsorption

A

anemia

osteopenia, tetany

amenorrhea, impotence, infertility

peripheral neuropathy, nyctalopia (decreased vit. A)

71
Q

…. results from malabsorption of any of the following: iron, pyridoxine, folate, B12, vit. K

A

anemia

72
Q

…. can result from malabsorption of Ca, Mg, vit D and protein

A

osteopenia, tetany

73
Q

…,…., and … can result from generalized malnutrition

A

infertility
impotence
amenorrhea

74
Q

… and … can result from malabsorption of vit. A and B12

A

peripheral neuropathy

nyctalopia (night blindness)

75
Q

if malabsorption is severe, initial oral sign is

A

atrophic glossitis (bald, reddish tongue)

76
Q

oral manifestations of malabsorption:

overt tongue lesions are usually….. and burning sensation (…) is a common complaint

A

tender

glossopyrosis

AU2017 Gen Path Exam 3 (12 decks)

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